术前血小板分布宽度与血小板比值联合血清甲状腺球蛋白可能是预测甲状腺乳头状癌的客观且可推广的指标。
Preoperative platelet distribution width-to-platelet ratio combined with serum thyroglobulin may be objective and popularizable indicators in predicting papillary thyroid carcinoma.
机构信息
The Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu, China.
Department of Proctology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
出版信息
J Clin Lab Anal. 2022 Jun;36(6):e24443. doi: 10.1002/jcla.24443. Epub 2022 Apr 20.
OBJECTIVES
The incidence of papillary thyroid carcinoma (PTC) has increased more rapidly than that of any other cancer type in China. Early indicators with high sensitivity and specificity during diagnosis are required. To date, there has been a paucity of studies investigating the relationship between preoperative platelet distribution width-to-platelet count ratio (PPR) and PTC. This study thus aimed to assess the diagnostic value of PPR combined with serum thyroglobulin (Tg) in patients with PTC.
METHODS
A total of 1001 participants were included in our study. 876 patients who underwent surgery for nodular goiter were divided into the PTC group or benign thyroid nodule (BTN) group according to pathology reports, and 125 healthy controls (HCs) were included. Preoperative hemogram parameters and serum Tg levels were compared among three groups. Receiver operating characteristic (ROC) curve was used to evaluate the value of PPR combined with serum Tg for diagnosing PTC.
RESULTS
Platelet distribution width (PDW) and PPR levels were higher in the PTC group than in the BTN and HC groups (both p < 0.05) but did not significantly differ between the BTN and HC groups. PDW and PPR levels significantly differed in the presence/absence of lymph node metastasis, the presence/absence of capsule invasion (p = 0.005), and TNM stages (p < 0.001). Multivariable analyses indicated that high serum Tg levels [adjusted odds ratio (OR), 1.007; 95% confidence interval (CI), 1.004-1.009; p < 0.001], high neutrophil-to-lymphocyte ratio (NLR,adjusted OR, 1.928; 95% CI, 1.619-2.295; p < 0.001), and high PPR (adjusted OR, 1.378; 95% CI, 1.268-1.497; p < 0.001) were independent risk factors for PTC. In ROC analysis, the areas under the curves (AUCs) of serum Tg, PDW, PPR, and NLR for predicting PTC were 0.603, 0.610, 0.706, and 0.685, respectively. PPR combined with serum Tg (PPR + Tg) had a higher diagnostic value (AUC, 0.738; sensitivity, 60%; specificity, 74.7%) compared with PDW + Tg (AUC, 0.656; sensitivity, 64.4%; specificity, 59.9%) and NLR + Tg (AUC, 0.714; sensitivity, 61.6%; specificity, 71.1%).
CONCLUSIONS
Preoperative PPR combined with serum Tg may be objective and popularizable indicators for effective predicting PTC.
目的
在中国，甲状腺乳头状癌（PTC）的发病率增长速度超过了其他任何癌症类型。在诊断过程中需要使用具有高灵敏度和特异性的早期指标。迄今为止，关于术前血小板分布宽度与血小板计数比值（PPR）与 PTC 之间关系的研究还很少。因此，本研究旨在评估 PPR 联合血清甲状腺球蛋白（Tg）在 PTC 患者中的诊断价值。
方法
本研究共纳入 1001 名参与者。根据病理报告，876 名因结节性甲状腺肿接受手术的患者被分为 PTC 组或良性甲状腺结节（BTN）组，另外纳入 125 名健康对照者（HCs）。比较三组患者的术前血常规参数和血清 Tg 水平。采用受试者工作特征（ROC）曲线评估 PPR 联合血清 Tg 对诊断 PTC 的价值。
结果
PTC 组的血小板分布宽度（PDW）和 PPR 水平均高于 BTN 组和 HCs 组（均 p<0.05），但 BTN 组与 HCs 组之间差异无统计学意义。PDW 和 PPR 水平在存在/不存在淋巴结转移、存在/不存在包膜侵犯（p=0.005）和 TNM 分期（p<0.001）方面存在显著差异。多变量分析表明，高血清 Tg 水平[校正优势比（OR），1.007；95%置信区间（CI），1.004-1.009；p<0.001]、高中性粒细胞与淋巴细胞比值（NLR，校正 OR，1.928；95%CI，1.619-2.295；p<0.001）和高 PPR（校正 OR，1.378；95%CI，1.268-1.497；p<0.001）是 PTC 的独立危险因素。在 ROC 分析中，血清 Tg、PDW、PPR 和 NLR 预测 PTC 的曲线下面积（AUC）分别为 0.603、0.610、0.706 和 0.685。PPR 联合血清 Tg（PPR+Tg）的诊断价值高于 PDW+Tg（AUC，0.656；敏感性，64.4%；特异性，59.9%）和 NLR+Tg（AUC，0.714；敏感性，61.6%；特异性，71.1%）。
结论
术前 PPR 联合血清 Tg 可能是有效预测 PTC 的客观且具有推广价值的指标。
Zotero 插件